Provider Demographics
NPI:1760624696
Name:MARTINEZ-VAZQUEZ, MAGA (MD)
Entity Type:Individual
Prefix:
First Name:MAGA
Middle Name:
Last Name:MARTINEZ-VAZQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DORADO DEL MAR
Mailing Address - Street 2:88 VILLAS DE GOLF ESTE
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:939-640-1431
Mailing Address - Fax:
Practice Address - Street 1:PLAZA DORADA SHOPPING
Practice Address - Street 2:845 CARR 693 SUITE 24
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646
Practice Address - Country:US
Practice Address - Phone:787-621-3322
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-24
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR20779207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology